Allopurinol-induced DRESS syndrome mimicking biliary obstruction.
- Author:
Hyung Gyu CHOI
1
;
Junsu BYUN
;
Chae Ho MOON
;
Jong Ho YOON
;
Ki Young YANG
;
Su Cheol PARK
;
Chul Ju HAN
Author Information
- Publication Type:Case Reports
- Keywords: DRESS syndrome; Allopurinol; Jaundice
- MeSH: Aged, 80 and over; Allopurinol/adverse effects; Biliary Tract/pathology; Biliary Tract Diseases/diagnosis; Bilirubin/blood; Creatine/blood; Drug Hypersensitivity Syndrome/*diagnosis/etiology; Endosonography; Eosinophils/cytology; Humans; Magnetic Resonance Angiography; Male; Tomography, X-Ray Computed
- From:Clinical and Molecular Hepatology 2014;20(1):71-75
- CountryRepublic of Korea
- Language:English
- Abstract: An 84-year-old man was admitted to our hospital with fever, jaundice, and itching. He had been diagnosed previously with chronic renal failure and diabetes, and had been taking allopurinol medication for 2 months. A physical examination revealed that he had a fever (38.8degrees C), jaundice, and a generalized maculopapular rash. Azotemia, eosinophilia, atypical lymphocytosis, elevation of liver enzymes, and hyperbilirubinemia were detected by blood analysis. Magnetic resonance cholangiography revealed multiple cysts similar to choledochal cysts in the liver along the biliary tree. Obstructive jaundice was suspected clinically, and so an endoscopic ultrasound examination was performed, which ruled out a diagnosis of obstructive jaundice. The patient was diagnosed with DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome due to allopurinol. Allopurinol treatment was stopped and steroid treatment was started. The patient died from cardiac arrest on day 15 following admission.
